DO NOT STOP TAKING YOUR PILLS

In 2023, the BBC released “The Antidepressant Story,” a film that details known, dangerous and sometimes permanent side effects associated with commonly prescribed antidepressants. The documentary features harrowing stories of former patients living with harm from SSRIs, or selective serotonin reuptake inhibitors. They caused persistent sexual dysfunction for a college professor in Iowa who wasn’t warned of its side effects. And they caused dependency in a psychiatric researcher from the UK, who, after ten years of taking it, found himself trapped on the drug after he wanted to stop. While the researcher had just completed his academic training to become a psychiatrist, he received no education at all on the withdrawal issues facing him, as well as more than 1 in 6 patients prescribed antidepressants. 

The Antidepressant Story, along with Medicating Normal, Take Your Pills, Anatomy of an Epidemic and Antidepressed are just a few of the growing collective of books and films exposing the overprescribing of psychiatric drugs to Americans, especially veterans. The side effects can be lifelong and sometimes fatal. The Food and Drug Administration does not require warnings for persistent sexual dysfunction, for example, and today the agency is attempting to defend itself from a lawsuit by the consumer advocacy nonprofit Public Citizen, which claims that it failed to respond to a 2018 petition to do so. The authorities that set clinical practice and prescribing guidelines—the Drug Enforcement Agency, and the Department of Health and Human Services — have also not updated their literature to reflect what we have learned about persistent sexual dysfunction or the very common dependency and withdrawal issues associated with some of the most commonly prescribed antidepressants on the market, such as Prozac, Zoloft, Celexa and others. This causes confusion for providers and unnecessary suffering for patients.

I wrote this article because of continued inaction by the FDA, DEA, HHS and the Department of Veterans Affairs to inform veterans, their families – and all Americans – of the dangerous risk profiles of the drugs they’re prescribed. To those who feel they are benefiting from these medications, I’m thankful you found a treatment to help you navigate the throes of depression, the crushing weight of anxiety, painful post-traumatic stress, or other challenging struggles. Still, you and your family should be aware of the possibility of side effects in the future and being made aware does not mean the doctor softly saying “Well, there are some known side effects, but how about we try this?” 

SSRI antidepressants and other blockbuster psychiatric drugs were released in the late 1980s and early 1990s. It seemed then that pharmaceutical companies had discovered scientific, targeted treatments for depression, free of side effects. But as the opioid epidemic taught us, silver bullet solutions are not simple or silver; they may come with great risks.

As the New York Times reported in 2018, patients who “try to stop taking the drugs often say they cannot.” It cited a survey of 250 long-term use of psychiatric drugs, mostly antidepressants, where “about half who wound down their prescriptions rated the withdrawal as severe. Nearly half who tried to quit could not do so because of these symptoms.” And a study in the National Library of Medicine of 180 longtime antidepressant users found that more than 130 reported withdrawal symptoms, “with some of those effects being severe and long lasting.” Nearly half said they believed they were trapped on the antidepressant drugs they were prescribed. Many were not aware of these risks prior to starting them.

The most severe side effect extends to suicidality and thoughts of self-harm. In 2004, in response to Kim Witczak and other surviving families, the FDA began requiring SSRI drugmakers to add a Box Warning on the packaging of all SSRI antidepressants related to suicide risk. A Box Warning, according to the American Medical Association, is “the most severe warning the FDA can place on a drug short of an outright ban.” Sadly, this class of drugs had been on the market for more than fifteen years before this warning was added. Through that lens, we should not be surprised to continue finding severe side effects with this class of medications. 

I understand these concerns all too well. In 2019, I published my story of withdrawal from an SSRI antidepressant known commercially as Zoloft. I shared my surprise and alarm when I tried to stop taking Zoloft after being prescribed the drug for a year and titrating down in dosage for two weeks. I experienced panic attacks, “brain zaps,” paranoia, thoughts of self-harm, physical pain—it was an excruciating year-long withdrawal.

Millions of others share this experience. For veterans, it’s especially challenging: 28% of all veterans treated at the VA are prescribed antidepressants and 68% are prescribed psychiatric drugs. The Government Accountability Office has shown that 94% of veterans treated at the VA for depression are prescribed antidepressant medications. 

The VA itself says that veterans between the ages of 18 and 34 are at the greatest risk of suicide. This group is also very commonly prescribed antidepressants, and this group, according to the FDA’s Box Warning, that’s at greatest risk of adverse events.

I share this with you and ask you to share it with others. Based on current prescription rates, you or someone close to you is likely taking an SSRI. Talk about potential side effects with your loved ones, friends, and family members. And to those now taking SSRIs—or any type of psychiatric medication—DO NOT ABRUPTLY STOP TAKING YOUR MEDICATIONS. If you have concerns or want to consider discontinuing your medications, only do so after consulting your prescriber. 

If you would like to learn more, please join us in Eaton Rapids, Michigan, on 15 October, 2024, for the "Michigan Veterans Harm Reduction Summit: Exploring the Relationship Between Medication & Veteran Suicide." This summit is hosted by the Grunt Style Foundation, in partnership with the Michigan Veterans Affairs Agency, the Michigan Commander's Group, the American Legion Department of Michigan and the VFW National Home. We will learn from some of the world's leading experts and clinicians on this issue, along with those who have lived these experiences themselves. We would be honored to have you join us as we learn about ways of reducing harm and increasing the quality of care within the veterans and military community! 

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About the author: Derek Blumke is the Grunt Style Foundation Veteran Impact Fellow; and Chair, Michigan Governor’s Challenge, Subgroup on Psychiatric Drug Safety.